What are the effects of methamphetamine use during pregnancy?

From the Guidelines

Methamphetamine use during pregnancy should be avoided completely due to significant risks to both mother and baby. If you are pregnant and using methamphetamine, seek medical help immediately to safely discontinue use under proper supervision. There is no safe level of methamphetamine use during pregnancy. Methamphetamine crosses the placenta and can cause premature birth, low birth weight, placental abruption, and birth defects. Babies exposed to methamphetamine in utero may experience withdrawal symptoms after birth and face long-term developmental and behavioral problems. For pregnant women with methamphetamine addiction, treatment should include comprehensive prenatal care combined with substance abuse treatment, which may involve behavioral therapy and counseling. Medication options are limited during pregnancy, but your healthcare provider can recommend appropriate treatments. Methamphetamine is particularly harmful because it constricts blood vessels, reducing blood flow to the placenta and limiting oxygen and nutrients to the developing fetus. It also increases heart rate and blood pressure, which can be dangerous during pregnancy. If you're struggling with methamphetamine use, tell your healthcare provider honestly about your substance use to ensure you receive appropriate care and support for both you and your baby.

Key Considerations

• Methamphetamine use during pregnancy poses significant risks to both mother and baby, including premature birth, low birth weight, and birth defects 1.
• Babies exposed to methamphetamine in utero may experience withdrawal symptoms after birth and face long-term developmental and behavioral problems.
• Treatment for pregnant women with methamphetamine addiction should include comprehensive prenatal care combined with substance abuse treatment, which may involve behavioral therapy and counseling.
• Medication options are limited during pregnancy, but your healthcare provider can recommend appropriate treatments.
• It is essential to prioritize the health and well-being of both the mother and the baby, and to seek medical help immediately if you are pregnant and using methamphetamine.

Recommendations

• Seek medical help immediately if you are pregnant and using methamphetamine to safely discontinue use under proper supervision.
• Be honest with your healthcare provider about your substance use to ensure you receive appropriate care and support for both you and your baby.
• Prioritize comprehensive prenatal care combined with substance abuse treatment, which may involve behavioral therapy and counseling.
• Follow the recommendations of your healthcare provider for medication options and treatment plans.

From the FDA Drug Label

Methamphetamine has been shown to have teratogenic and embryocidal effects in mammals given high multiples of the human dose. There are no adequate and well-controlled studies in pregnant women Methamphetamine hydrochloride tablets should not be used during pregnancy unless the potential benefit justifies the potential risk to the fetus. Infants born to mothers dependent on amphetamines have an increased risk of premature delivery and low birth weight Also, these infants may experience symptoms of withdrawal as demonstrated by dysphoria, including agitation and significant lassitude.

Methamphetamine use in pregnancy is associated with potential risks, including:

• Teratogenic effects: Methamphetamine has been shown to have teratogenic and embryocidal effects in mammals.
• Nonteratogenic effects: Infants born to mothers dependent on amphetamines have an increased risk of premature delivery and low birth weight, and may experience symptoms of withdrawal. Methamphetamine hydrochloride tablets should not be used during pregnancy unless the potential benefit justifies the potential risk to the fetus 2 2.

From the Research

Methamphetamine Use in Pregnancy

• Methamphetamine abuse during pregnancy is associated with an increased risk of preeclampsia and hypertension, fetal demise, preterm delivery, and intrauterine growth restriction 3.
• The deleterious effects of prenatal methamphetamine exposure on the developing fetal brain may lead to long-term neuro-developmental and behavioral problems 3.
• Methamphetamine use during pregnancy is associated with shorter gestational ages and lower birth weight, especially if used continuously during pregnancy 4.
• Stopping methamphetamine use at any time during pregnancy improves birth outcomes, thus resources should be directed toward providing treatment and prenatal care 4.

Effects on Child Health

• Methamphetamine exposure during pregnancy may lead to long-term neuro-developmental and behavioral problems in children 3.
• Infants with positive toxicology at birth were smaller than infants with first trimester exposure only, and had a clinically relevant shortening of gestation 4.
• Methamphetamine use during pregnancy contributes to adverse maternal and neonatal outcomes, including lower birth weight and shorter gestational ages 5.

Care and Treatment

• A multi-disciplinary approach is needed to improve care of affected women and families, including good prenatal care, perinatal care by specialized obstetricians and neonatologists, and psychiatric treatment by an addiction specialist 3.
• Harm reduction describes a framework for conceptualizing substance use by championing health promotion and the safest use of substances, as opposed to the unachievable goal of abstinence 5.
• Best practice guidelines for care in the labor and birth setting of pregnant women who use methamphetamines include universal screening, assessment, and management of analgesia during labor, as well as broad guidance regarding the inclusion of a multidisciplinary health care team 6.
• Safe, dignified, and compassionate care approaches are focused on communication, shared decision making, and the provision of nonjudgmental care 6.

Comparison with Other Substances

• While opioid use disorder has evidence-based pharmacologic interventions for long-term treatment, methamphetamine use has limited evidence-based interventions 5.
• Methadone and buprenorphine are important treatment options for opioid abuse during pregnancy, but there is no evidence to suggest that buprenorphine is better suited to treatment of prescription opioid abuse than methadone 7.